Opinion

This page has information and links that we have found useful in our own experience of caring for an elderly relative with Alzheimer's.

The challenges of cqc data 14-02-2012

I passed a care home last week that had a large banner outside saying "awarded the highest possible rating by the CQC".  This may have been true once but the Care Quality Commission haven't awarded ratings since July 2010 so it's not very current.

It's a struggle to keep getting the CQC data into a form where we can use it on Carehomemap site.  We had to change everything once to decipher the format that was used from August 2010 but CQC changed it again in October 2011 and after this we were not able to get a list of current homes.  We requested this information from CQC several times but it took a Freedom of Information request to finally obtain it:

http://www.whatdotheyknow.com/request/request_for_a_list_of_all_care_hWe are hoping that the format stays fixed now so that we can continue to use the tools that we have developed to extract it.  We think that carehome quality data should be freely and easily available to everyone.

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Dementia Sufferers Vulnerable to Con Artists 14-12-2011

The Alzheimer's Society has calculated that 15% of people with dementia have been victims of financial abuse from cold calling, scam mails etc. losing an average of £850 each. 

Full article: http://www.bbc.co.uk/news/business-16167995

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Government announces plans for its own CareHomeMap 14-12-2011

Following consultation with care users and their relatives the government's Care Home Minister Paul Burstow has announced plans to create a web site that allows members of a care home user's family to rate and review care homes which he believes "will revolutionise the way people and their loved-ones choose their social care".
The goverment will produce a white paper in Spring 2012.  In the meantime please carry on using the CareHomeMap web site as this has had all of this functionality since its launch in February 2010.

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National Audit Office finds problems with CQC 02-12-2011

A National Audit Office report finds that the CQC has experienced serious difficulties and that levels of compliance of health and social care providers and inspection activity has fallen significantly.

They also found that as a result of the CQC moving inspectors from compliance to inspections and a shortage of inspectors fewer than half of the target number of compliance reviews were completed between October 2010 and April 2011.

Full report is here: http://www.nao.org.uk/publications/1012/care_quality_commission.aspx

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Another format change for CQC 22-11-2011

CQC have launched another new web-site and the previous site is archived as it was on 19th October 2011.  CareHomeMap is now attempting to get to grips with extracting information from the new web-site. 

CQC have announced that they will start inspecting home care providers - the companies that provide staff who help people to stay in their own homes.  Full BBC article here http://www.bbc.co.uk/news/mobile/health-15831639?SThisEM

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CareHomeMap displays CQC Outcomes and Licences 14-10-2011

In July 2010 the Care Quality Commission (CQC) stopped providing ratings for Care Homes and switched to a system of outcomes and licences.

There are 16 core outcomes, grouped into six categories, described in this document http://www.cqc.org.uk/_db/_documents/Summary_of_regulations_outcomes_and_judgement_framework_FINAL_081209.pdf

When a CQC inspection takes place the inspector decides which outcomes are appropriate and records whether there are: no concerns, minor concerns, moderate concerns or major concerns about it.

The CQC also maintains a set of licences for each home which record whether the home is licenced, for example, for treatement of disease, disorder or injury.  A licence can be recorded as licenced or licenced with improvements required.

CareHomeMap has now added this information to its web-site.  Although it's tempting to assume that an outcome with moderate concerns is the same as an adequate rating in the old system the CQC specifically warns about using the outcome system as a rating.  CareHomeMap has accomodated this by displaying old rating information and new outcome information side by side.

Many homes appear to have taken the opportunity to register under the new system with a different name in order to start with a clean inspection history.  As homes with different names at the same postcode are displayed side by side on the CareHomeMap map it is quite straightforward to match them up.  Some homes appear to have taken the opportunity to change their postcode and this is harder to match up but a bit of digging around on the map will usually find the predecessor.

As usual please email any comments to 


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HMRC and Power of Attorney (2) 28-06-2011

Following up on this one (see post from 8th April) I had not received a reply to my registered letter after two months and I had also received a new letter from another tax office to say that my mother had underpaid for the previous tax year. 

I rang the Taxes Helpline 0845 3000 627.  They told me that there were not able to talk to me as I am not the registered power of attorney and they were not able to tell me who the registered power of attorney was.  I'm assuming that this is my brother although we have joint power of attorney so HMRC had no right in law to register him as sole contact. 

I told them that the reason that I was calling was to follow up my registration as power of attorney and to find out why they had not returned the Power of Attorney document that I had sent two months earlier (as this was the original document I had sent it registered post and asked in the covering lettter for it to be returned as soon as possible).

They still refused to discuss this with me and said that they had no way of contacting the office that I had written to.  I told them that my brother is now forwarding all letters from them to me unopened and that as they would not accept that I have power of attorney I would not be able to act for my mother any more or file any more tax returns for her until they recognize my power of attorney and update their address records.

I turned out that they had returned the Power of Attorney document a month after they received it - to the wrong address of course.

From this I conclude that it's best to not send any original copies of important documents to HMRC as their administration is very poor.  Next I am going to write to them to formally give notice that due to their lack of action no-one is now acting on my mother's behalf with regards to tax matters and that no further returns will be filed until they correct this.

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Southern Cross - GMB Report 07-06-2011

The GMB union has published a 61 page report about the financial moves that led to the current crisis at Southern Cross.  The 31,000 residents of Southern Cross care homes face an uncertain future as Southern Cross takes desperate measures to avoid bankruptcy.  Four of the former executives of Southern Cross made profits of over £35m between them when the company was floated in 2006.

http://www.gmb.org.uk/newsroom/latest_news/the_greedy__the_gullible.aspx

The Daily Mail has alleged that Jeremy Heywood, a key aide to Tony Blair and David Cameron who is tipped to become the next Cabinet Secretary, may have profited personally from the flotation as he was in charge of the team at Morgan Stanley that was responsible for it.

http://www.dailymail.co.uk/news/article-1395038/Southern-Cross-Blairs-aide-Jeremy-Heywood-dragged-scandal.html?ITO=1490

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UK Care Homes in Crisis 31-05-2011

The Financial Times (FT) has published a series of major articles about the state of Care in the UK.

We provided FT journalist Cynthia O'Murchu with some views of our data to assist with the article and carehomemap web site is featured in the video on the FT web-site.

The video and some of the articles are available on this link http://video.ft.com/v/963687158001/UK-care-homes-in-crisis

We are very pleased to see the FT drawing attention to these problems with such a comprehensive set of articles.

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New CQC reports 26-05-2011

The Care Quality Commission (CQC) has started to produce inspection reports again and are now posting these on their web-site:  http://caredirectory.cqc.org.uk/caredirectory/searchthecaredirectory.cfm

The format of reports has changed so that instead of awarding quality ratings across different categories they are now recording the outcomes from checks of up to 30 different standards. 

A typical standard is Food and drink should meet people's dietary needs

An outcome can be:

Standard is met
Minor concern
Moderate concern
or
Major concern.

At carehomemap we are trying to work out how to incorporate this new way of assessing homes into our framework.

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CQC response to Which? Investigation 28-04-2011

The response to the Which? article from head of the Care Quality Commission Dame Jo Williams concludes:

"Care professionals and managers in health and social care are closest to those who use services and have a duty to take steps to stop or report poor care whenever they see it."

It makes you wonder what the point of having a Care Quality Commission is if they think that it's up to the people who work in homes to monitor quality.  What happens if a home is managed by people who are more interested in profit than in the quality of care?

The full response is here

http://www.cqc.org.uk/newsandevents/newsstories/jowilliamsrespondstowhichreport.cfm

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Which? Undercover Investigation 28-04-2011

Which? has carried out an undercover investigation of care homes by sending actors into four UK homes.

What they found in one home has resulted in the CQC suspending admissions and launching an investigation.

The full article is here

http://www.which.co.uk/campaigns/food-and-health/care-homes-investigation/which-care-homes-investigation/

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HMRC and Power of Attorney 08-04-2011

I look after my mother's financial affairs under Lasting Power of Attorney.  We filed a tax return for her by post at the end of October 2010.  In March 2011 we received a letter from HMRC saying that we were being fined as we had failed to file a return.

We checked bank records and found that the cheque that had been sent with the return had been cashed by HMRC at the beginning of November.

A week after the letter about the fine arrived we received the original tax return back from HMRC.  They had rejected it as I had signed it and they had no record of my Lasting Power of Attorney.  Unfortunately HMRC had incorrectly addressed this letter, by missing out the house number, and it had taken 5 months to arrive.

I have now sent Lasting Power of Attorney document by registered post, asked HMRC to correct their address record and appealed the fine.

We filed by post originally as we didn't have a UTR number to file online.  Presumably if we had been able to file online we wouldn't have needed to register Power of Attorney with HMRC as no signature is required.

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New Rating System announced 01-03-2011

After pressure from various organisations the Care Quality Commission (CQC) has announced a new rating system. 

http://www.bbc.co.uk/news/health-12595486

The Independent newspaper is worried that as homes will have to pay for an inspection it will prevent smaller homes from applying.  It is also concerned that private companies may be used for regulation which could lead to commercial considerations affecting impartiality.

http://www.independent.co.uk/opinion/leading-articles/leading-article-the-dangers-of-a-circuitous-approach-2227534.html

Consultation will start in May and CareHomeMap will be asking for information about how data quality will be assured.  We will also ask if any further information will be provided about homes that do not register for the new rating system as we think that what's provided since the previous rating system was scrapped is inadequate.

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Nobody noticed when CQC ratings were scrapped 11-02-2011

In a letter to the Independenent Jane Ashcroft, chief executive of Anchor, pointed out that there was little media attention when the CQC star ratings were scrapped - these were "crucial tools for people having to make hugely important decisions"

http://www.independent.co.uk/opinion/letters/letters-perspectives-on-broadcasting-2202515.html

She had made the same point in May 2010 when the announcement was made

http://www.communitycare.co.uk/Articles/2010/05/21/114557/anger-over-cqc-decision-to-end-star-ratings.htm

The http://www.carehomemap.co.uk/ web-site allows user ratings to be added and viewed.  These can be used as a replacement to the CQC star system once there are enough of them.

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The CQC's perspective 31-01-2011

Dame Jo Williams has recently been appointed as the chairwoman of the Care Quality Commission.


In an interview with the Independent she says that she's worried that public sector cuts at council level will result in less money being paid to care homes which will lead to lower standards.  


She says that the CQC is going to start using automated methods of scanning information in from newspapers and the net to alert them to problems.  Full article here: 

http://www.independent.co.uk/life-style/health-and-families/health-news/dire-state-of-care-homes-for-the-elderly-is-only-going-to-get-worse-says-top-inspector-2195530.html

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There is another way 29-01-2011

A letter from Libby Smith In response to Johann Hari's article suggests a "mutual" alternative to the current private equity funded model of care home provision:
"Johann Hari's plan for improving the lives of elderly people in care homes is good, but how long do we think it'll take for government to put it into action? Another solution could be for residents to own and manage their own care homes by setting up peer-led social enterprises, co-ops, mutuals, etc. Groups of like-minded people could club together, buy their own property and employ the care, cleaning and cooking staff they need.
They would choose how small or large their homes would be, who they live with, whether pets are allowed, etc. If they own the property, the costs would probably compare favourably with commercial care homes. But this would work better if people took the plunge before they actually needed care. As members die, their places would be bought by younger members, perhaps friends of existing members.
And yes, people would deteriorate physically and mentally, but not all of them and not all at the same time. So people needing care would be surrounded by friends more able-bodied or able-minded, and some would have their spouses, reducing the need for care workers simply to watch over residents."
Full text here:

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Johann Hari's 10 point plan for change 26-01-2011

The newspapers are so full of people moaning about things that it's really encouraging to see that Johann Hari has produced a 10 point plan for how to improve quality of care

http://www.independent.co.uk/life-style/health-and-families/features/the-plan-to-solve-our-care-home-crisis-2194213.html

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A banker's point of view 25-01-2011

Private equity companies are eyeing up the collapsing Southern Cross group of care homes.  Stuart Quint from 3i is quoted in an article in the Observer "We are on the look-out for opportunities, particular where we can charge a premium for specialist services in areas such as learning difficulties, dementia, brain injuries and Huntington's disease."

Full article here http://www.guardian.co.uk/business/2011/jan/23/southern-cross-care-homes-private-equity

Meanwhile my local council (Haringey) is planning to close all of its care homes by 2013 which will mean that all care in Haringey will be provided by the private sector
http://www.hornseyjournal.co.uk/news/age_matters_director_warns_of_transplantation_shock_for_old_folk_moved_out_of_homes_in_haringey_1_771271

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CQC inspections cut by 75% 18-01-2011

Johann Hari writes in The Independent newspaper about his experience of finding acceptable care for his Grandmother:

http://www.independent.co.uk/opinion/commentators/johann-hari/johann-hari-my-grandmother-deserved-a-better-ending-than-this-2184337.html

He notes that the Government's new "light touch regulation" has cut the number of Care Home inspections to a quarter of what they were.  This is in line with our experience at CareHomeMap.co.uk.  We used to upload inspection reports every three months but these are no longer available and we have not uploaded any updates since August 2010.

The CQC web site has almost no information on it now - it's hard to see how this is a step forward.

We are hoping that users of CareHomeMap.co.uk will make more use of the user rating functions so that we can start to build an up to date picture of care quality.

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Paul Burstow announcement - A vision for adult social care 17-11-2010

Care Services Minister Paul Burstow has announced his vision for social care:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508

Response from the Alzheimer's Society

http://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=836

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Paying care home fees 02-11-2010

This excellent article on Citywire looks at ways of funding long term care.
http://m.citywire.co.uk/money/long-term-care-your-questions-answered/a444447?re=11620&ea=51797


They estimate that the average cost of a place in a nursing home is £36,000 rising to £50,000 a year for a good home in the South East.

Of the 8,211 homes in England that have specified their minimum fee rate in their latest CQC report we have calculated that the average is £31,400.  You can see fee information for the whole of England or for any county or London borough by selecting the fees filter on the CareHomeMap regions page
http://www.carehomemap.co.uk/Regions.aspx?Category=Fees
.

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Grim news on care home funding 30-10-2010

This article on the channel4 web-site makes worrying reading about the future of care home funding and standards http://www.channel4.com/news/care-home-crisis-as-funding-cuts-loom

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CQC Quality Ratings 01-10-2010

CQC have decided to stop providing quality ratings and the last set were issued at the end of June 2010.  They have carried out a consultation and will launch a new process in May 2011.  How we are supposed to get an idea of the quality of a home that opens between July 2010 and May 2011 is unclear.

Their document about this is here
http://www.cqc.org.uk/guidanceforprofessionals/adultsocialcare/changestoourassessmentsystem.cfm


The results of the consultation process are here
http://www.cqc.org.uk/_db/_documents/Analysis_of_consultation_on_CQC_assessments_2010-11_201009133532.pdf

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Cuts to public spending hit Care Homes 10-09-2010

This article in the Guardian highlights how cuts to local authority spending is affecting Southern Cross - the UK's biggest Care Home operator http://www.guardian.co.uk/business/2010/aug/09/southern-cross-care-home-profits.

The group's solution is to sell off the freeholds of their homes and lease them back http://www.nebusiness.co.uk/business-news/latest-business-news/2010/04/22/southern-cross-home-group-s-bid-to-be-debt-free-51140-26291819/.
which is the same strategy as Woolworths took before going into administration.
http://www.telegraph.co.uk/finance/newsbysector/retailandconsumer/3699784/Comment-Woolworths-comes-full-circle.html

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